WASHINGTON, D.C. – The plea for a 90-day meaningful use reporting period for 2015 isn't political posturing. It's the difference between a majority of providers dropping out of the incentive program or not, say College of Healthcare Information Management Executives (CHIME) members representing U.S. healthcare CIOs at National Health IT Week.
Utah's biggest healthcare provider, Intermountain Healthcare, will not even be budgeting for stage 2 attestation in 2015 if the current 365-day reporting period isn't reduced, CIO and VP of Information Systems Marc Probst told SearchHealthIT.
"We will be budgeting for the penalties that will be associated with it," he added, referring to CMS's docking claims reimbursements for providers who skip meaningful use.
It appears it will take an act of Congress to fix the problem, and that's in the works. Running an end-around the Obama administration, U.S. Rep. Renee Ellmers (R-NC) introduced H.R. 5481, The Flexibility in Health IT Reporting (Flex-IT) Act of 2014 after healthcare providers were rebuffed in their request for a 90-day period.
"The Meaningful Use Program has many important provisions that seek to usher our health care providers into the digital age," Ellmers said in a statement. "But instead of working with doctors and hospitals, HHS is imposing rigid mandates that will cause unbearable financial burdens on the men and women who provide care to millions of Americans. Dealing with these inflexible mandates is causing doctors, nurses, and their staff to focus more on avoiding financial penalties and less on their patients."
Capitol Hill chatter indicated that health IT lobbyists were working overtime to help Ellmers find a Democrat to co-sign the bill.
ONC too rosy in stage 2 attestation predictions?
Probst said he's not surprised that, as of early September, there were only 143 hospitals and 3,152 physicians attesting to stage 2, numbers that represent paltry percentages of their stage 1 counterparts.
His health system, amid a new Cerner Corp. EHR implementation, is in its second year of stage 1 attestation for 2014. Once the entire health system goes live on Cerner, Probst is confident Intermountain will attest to stage 2. But that won't happen in 2015, as the health system rolls the system out in six territories, one at a time.
The hybrid environment of old and new EHRs causes a slew of meaningful use attestation problems, from data normalization for reporting purposes to maintaining levels of electronic physician order entry required for meaningful use as practitioners learn how to use the new EHR system.
Other providers who aren't ripping and replacing their EHR systems will have their own problems getting to stage 2, Probst said. Because of that, he thinks ONC is interpreting attestation statistics too optimistically, with its predictions that 50% of providers who attested to stage 1 will eventually make it to stage 2.
"The goal can't possibly be 50%," Probst said. "It doesn't seem realistic to me, if you look at where everyone is now."
However, he doesn't fault national health IT coordinator Karen DeSalvo, M.D. for the meaningful use quandary in which healthcare providers find themselves.
"She's come in at the most difficult time to be coordinator," Probst said. "The money's gone, the expectations are high. But her heart's in the right place. The question is, can she get the right people to focus on the right problems? We'll see."
Health IT leaders mobilize for political fight
A letter to HHS Secretary Sylvia Burwell signed by CHIME and 16 other healthcare groups including the American Medical Association, American Hospital Association and the American Academy of Family Physicians demanding a 90-day meaningful use reporting period for 2015 probably isn't going to get it done.
CHIME panelists, part of a group of ONC representatives and physician associations gathered in the Russell Senate office building to discuss health data, focused the discussion on the reporting period at every opportunity.
"Going into a 365-day reporting period at this time is going to be very burdensome, it's enough of a burden to get to 90 days...the reporting part is a tremendous amount of work," Randy McCleese, outgoing CHIME President as well as VP and CIO of St. Claire Regional Medical Center in Morehead, Ky. told SearchHealthIT.
"It's taking a lot of resources away from direct patient care...that's been one of the issues we've had the last two-and-a-half to three years with meaningful use."
McCleese said that meaningful use has squeezed St. Claire's resources in two ways. First, the cost of attesting has burned funds that would have been devoted to patient care, and led to some practitioner layoffs. Second, it's taken some frontline practitioners away from patient care to concentrate on gathering data and reporting it.